Case report of a 33-year-old patient with a niche in a cesarean section scar

Worldwide, cesarean section procedures are being performed with increasing frequency, which is associated with a growing number of postoperative complications. One of these is the formation of a triangular, anechoic defect of the uterine myometrium at the site of a previous cesarean section scar, referred to as a niche. This condition may lead to abnormal bleeding, pain, fertility problems, and complications in subsequent pregnancies. This paper presents the case of a 33-year-old patient with a history of two cesarean sections, in whom ultrasonographic examination revealed a defect within the scar measuring 4 mm in depth, consistent with a so-called niche. The patient expressed an intention to conceive again; however, the presence of the defect constituted a significant risk factor for complications during pregnancy. The importance of accurate diagnosis and appropriate management of the niche before a planned pregnancy was emphasized to minimize the risk of serious complications, such as uterine scar dehiscence. This case highlights the need for proper management of women with a cesarean section scar who are planning subsequent pregnancies.